Richard is in my group this morning, and I suddenly feel like I am performing more than facilitating a therapy session. He’s sitting next to a relatively new kid named Devon. Devon is my age and surprisingly stylish. Today he’s wearing designer jeans, distressed black leather shoes that extend too far out and look like cartoon cowboy boots, a gray athletic T-shirt and a pretty badass leather motorcycle jacket. Not the kind you pick up at a department store for nine hundred dollars; the kind guys who actually ride motorcycles wear. His long dreads are twisted into a thick ponytail. If I had seen him under different circumstances, I might have said he was hot. Except for the shoes.
Devon is diagnosed with schizophrenia, disorganized type. This isn’t particularly common here; most of the patients with schizophrenia are diagnosed with paranoid type. People outside these walls call it paranoid schizophrenia, but when I’m here I have to say it the right way.
He sits with his legs twisted around each other, at the edge of his seat, constantly wringing his hands together and twisting his arms around one another. At several points during today’s group, he looked like he was about to tip over. After a few groups, Devon began standing up in this position. He would perch on one bent leg with the other leg twisted around it, holding his arms out in front of him and eventually doing something that looked like martial arts. He would shadow box standing like that; he would move his arms in slow, concentrated motions like tai chi. This was both fascinating and distracting.
I’m seeing Devon twitch and perch now, and I’m inwardly terrified of how this is going to affect the other patients—particularly Richard. I’m watching him with one eye while keeping the other eye on the group. Richard is keeping to himself; he’s arranged it so there’s more than one chair between him and any other patient, but he is looking up from his papers over his glasses, and he is noticing Devon. The other patients start to become wary of Devon’s behavior, and some become obnoxious and say they don’t want to be around this weirdo and I should kick him out of the group.
“No one is getting kicked out, Barry. Take it easy.” I lean back on the desk.
“Nah, man, this dude is weird, I don’t want none of his weird getting on me, man. He distractin’ the group! He shouldn’t be in here!” Barry likes to be the peacekeeper while not keeping the peace at all. He frequently causes uproars in the name of justice and the betterment of the group process. I think Barry makes big scenes to distract himself from the voices in his head.
“Barry, since you’ve elected yourself to be the spokesman for this group, why don’t we follow your lead and talk about stigma.” Everyone hates when I do this.
“Aww, Miss Sam, can we not? I’m tired of talkin’ ’bout stigmata.”
“Stigma.”
“Whatever you call it. I’m tired of it.”
“Okay. First of all, what is stigma? What does it mean?”
“Stigma is like prejudice, right? Like when you an asshole to someone because of how they look, or being black or something, right?” This is Lucy. Lucy is seventeen. She wears sexy outfits and too much makeup. She has bipolar disorder. Some days she is so with it, I want to send her to Harvard, and some days she can’t tell you her name.
“That’s right, Lucy. Good job. Stigma is a lot like prejudice. It’s a negative belief that exists about a member of a group that is based solely on group membership. Anyone ever have experience with that?” Sometimes, I’m more of a teacher than anything else. When I get into a good discussion, I start kicking my heels against the front of the desk. We are not supposed to be sitting on the desks; it’s another one of the rules about making sure we keep a proper level of separation between “us” and “them.” The longer I’m here, the less I care about this separation.
Everyone raises their hands to indicate they have been stigmatized in the past. Even Richard has his hand up. Devon is the only one who doesn’t respond. I call him out.
“Devon, you see everyone else has their hands up? This has never happened to you?” I’m trying to involve him, not alienate him, but I fear I’ve made the wrong impression. He looks at me and seems to say something.
“I’m sorry, Devon, I can’t hear you from all the way up here. Can you say that one more time?” He responds again, this time unlocking his chin from his neck and seemingly trying to project.
“I’m sorry, still can’t hear you.”
“He says he stays away from people.” Stephan.
“Thank you, Stephan. Sometimes it’s hard to hear. So, Devon, you stay away from people? Is that to avoid being stigmatized?”
He nods.
“It hurts to be the victim of stigma, doesn’t it?”
He nods.
Everyone else nods.
“What kinds of things do you think other people believe about people with mental illnesses? What kind of stigma have you experienced?”
“People say we’re crazy.” As Stephan says this, I start writing the words on the blackboard behind me.
“Lazy. Uneducated. Stupid.” Barry.
“People say we a burden. Like we don’t do nothin’ to help America.” This is Lucy again.
“Dangerous.” I’m surprised at who this is coming from. Adelle is about a hundred years old. She is as frail as they come, and I wouldn’t imagine she experiences the stigma of being dangerously mentally ill. Then I remember that while off her meds, Adelle once stabbed a man in the chest with a pair of scissors.
“Dirty. Disgusting. People don’t want to stand near us. Even we don’t want to stand near each other.” Darryl says this. Darryl is suffering from a traumatic brain injury that resulted from a self-inflicted gunshot wound to the head. He still struggles with major depression, but he swears he will never attempt suicide again. His wife left him after the incident because she couldn’t bear to look at him with the resulting disfigurement.
“Alright, I’ll say it: they say we’re weirdos.” This is Barry making amends. He looks at Devon. “Sorry, man, you don’t need me calling you a weirdo when everyone else already does.”
Devon nods.
“Thank you for that, Barry; that was very nice of you. What else, guys? What are some other stigmas you’ve experienced due to mental illness?” I see Richard looking at Barry, seemingly approving of his apology.
“People think they could catch it from you. Like if they have sex with you, they could get bipolar.” Lucy.
“Does anyone know if that’s true or not?” Me, I’m trying to teach without making the patients feel like they’re in school. I’m looking at Richard, but his head isn’t in the room.
“Nah, you could get AIDS and shit, but you don’t catch crazy.” Barry.
As I’m writing all the words on the board, I’m beginning to feel guilty because I’ve held every single one of these beliefs. I feel simultaneously sad and defensive.
As the group finishes, I wait for everyone to file into the hallway. I am walking around the room putting the chairs back into a semicircle, picking up the garbage left by the patients. As I walk past the chair that Devon squeezed into the corner, I notice little flakes, like paint chips or confetti, scattered at the base of his seat. I brush them onto the floor and keep walking.
I erase the board, making a mental note of all the words written, wondering how often I’ve felt stigmatized. Wondering